Antibiotic Utilization and Antimicrobial Stewardship in Community Hospitals

BACKGROUND: Overthe use of antibiotics has been associated with the emergence of antibiotic resistance. This study aims to evaluate trends in antibiotic utilization as defined by days of therapy per 1000 patient-days (DOT/1000 PD) in various community hospitals across the US. METHODS: Eighteen network hospitals provided antibiotic utilization data (2012–2016) on overall antibiotic use and the following classes: narrow-spectrum β-lactams (ampicillin, nafcillin, oxacillin, cefazolin, and cephalexin), non-carbapenem antipseudomonal β-lactams (piperacillin/tazobactam, ceftazidime, and cefepime), carbapenems, anti-methicillin-resistant Staphylococcus aureus (MRSA) agents (vancomycin, linezolid, daptomycin, and tigecycline), and fluoroquinolones. Antibiotic utilization and change in utilization trend during the study period was calculated using linear regression (β coefficient). RESULTS: Hospitals were primarily urban (72%) with an average of 209 total beds and 22 ICU beds. All hospitals have antimicrobial stewardship programs (ASPs) established during the study period. A decrease in antipseudomonal B-lactams and fluoroquinolones was observed during the study period, all other antibiotic classes had increased use (Table). CONCLUSION: Overall antibiotic utilization increased over five years, particularly carbapenems and anti-MRSA agents with the highest utilization being reported with the latter. Efforts are needed to halt or decrease the use of these broad spectrum antimicrobials. DISCLOSURES: All authors: No reported disclosures.